Maxillofacial Mucormycosis

INTRODUCTION: Mucormycosis emerged as a wildfire in post-covid-19 infected patients. Most frequently involved sites of mucormycosis are rhino-orbital, rhino-sinusal and rhino-orbito-cerebral. The hallmark sign of mucormycosis is tissue necrosis, which is often a late sign. The fatality rate of mucormycosis is 46% globally. Despite early aggressive combined surgical and medical therapy, the prognosis of mucormycosis is poor. METHODS: We searched the electronic database of PubMed, web of science, Embase, Scopus and Google Scholar from Jan 2020 until December 2021 using keywords...

BACKGROUND AND AIM: Biting forces from the teeth are distributed to the facial bones and to the skull through the stress trajectories. The presence of a bony defect in either the maxilla or mandible might lead to variations in the stress distribution. The aim of this study was to evaluate the stress distribution and variations in stress trajectories from biting forces in a human skull with maxillofacial defect using a finite element (FE) model. METHODOLOGY: In this study, a cone beam computed tomography (CBCT) of an adult male patient with a maxillectomy defect consequent to surgical treatment of mucormycosis is evaluated for the stress distribution from the biting forces of the remaining posterior teeth...

Rehabilitation in Low level maxillectomy cases has plethora of options right from local flaps to microvascular flaps. Subsequent to flap surgery, a maxillary dental rehabilitation can be demanding and a fixed or removable prosthesis is obligatory to provide them with near-normal function and aesthetics. Unlike the original ZIP flaps which were dedicated to microvascular flaps, we present here our unique experience with ZIP-Temporalis flap specifically for rehabilitation for patients of CAM (covid associated mucormycosis), its methods, advantages and limitations...

Aim of our study was to report unusual presentation of mucormycosis in patients, who were recovered from COVID-19 infection. This was a prospective observational study, undertaken at Ravindra Nath Tagore Medical College, Udaipur, India, over a period of last 3 months (April-June 2021). All patients with maxillofacial and dental mucormycosis were included in the study. All patients either have COVID-19 infection or recovered from it. Eight (40%) patients had history of use of corticosteroids for COVID1-19 infection, fifteen patients had either known case of diabetes or newly diagnosed diabetes with uncontrolled blood sugar at the time of presentation, three (15%) patients were in pre-diabetic state with HbA1c between 6...

PURPOSE: To evaluate the prevalence of risk factors associated with COVID-associated mucormycosis (CAM) in the maxillofacial region with emphasis on clinical and radiological characteristics of the disease reporting to the dentists. METHODS: Archival records of the patients diagnosed with rhino-cerebral mucormycosis through histopathology or culture, were screened and 266 records were included. These records were divided into three groups-previously diabetic (PD, n = 122), recently diagnosed diabetic (RD, n = 105) and non-diabetic (ND, n = 39)...

INTRODUCTION: Mucormycosis is an acute and rapidly progressing opportunistic fungal infection. COVID-19-associated mucormycosis (CAM) had re-emerged as a complication of COVID-19 infection during the second wave of the pandemic in 2021. The rhinomaxillary form is a variant of the rhino-cerebral mucormycosis that presents a diagnostic challenge to the dentist and the oral and maxillofacial pathologist. Gross examination of pathological specimens is the most undermined step even though it plays a vital role in the final diagnosis...

CONTEXT: Mucor circinelloides is reported to be the second among the most common causative agents of emerging mucormycosis. It is intrinsically resistant to most known antifungals. Further the use of antifungals cause side effects. Traditional knowledge system for treating various ailments is stronger in India and it also backs deriving various bioactive compounds from herbal sources, in the modern system of medicine. Therefore, two most commonly used culinary herbal materials viz., ginger and omam were studied in vitro against M...

A recent increase in the prevalence of mucormycosis of the head and neck in patients who have recovered from COVID-19 following hospitalization has been reported. A Majority of the cases have been reported from India. Conditions such as diabetes mellitus, use of corticosteroids for other autoimmune conditions, organ transplant, immunosuppression, immunodeficiency, and malignancies especially hematologic ones, are all known risk factors for mucormycosis. Recently, hospitalization for COVID-19 has been added to the list of risk factors for opportunistic mucormycosis infection...

UNLABELLED: Mucormycosis is an angio-invasive rapidly progressing fungal infection, usually reported in immunocompromised individuals. We present a case of COVID-associated mucormycosis in a patient with a presenting symptom of toothache in the maxilla with a possible mild case of COVID-19. ABSTRACT: Coronavirus-associated mucormycosis (CAM) had reached epidemic status, especially during the second wave of COVID-19. It was especially prevalent in India with a large mortality rate...

The rehabilitation of facial deformities is a challenging endeavour that necessitates customising the procedure for each patient. Significant physical and psychological impacts might arise as a result of the deformity in the orofacial region. Post-COVID rhino-orbital mucormycosis has led to rise in extraoral and intraoral defects since 2020. To avoid further surgery, an economical maxillofacial prosthesis is an excellent choice as it is aesthetic, durable, long-lasting and retentive. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis maxillectomy and orbital exenteration using a magnet-retained closed bulb hollow acrylic obturator and room-temperature vulcanising silicone orbital prosthesis...

INTRODUCTION: Patient-specific implants aided by 3D virtual planning and CAD-CAM technology represents the next frontier in rehabilitation of complex maxillofacial defects slowly replacing the gold standard autografts as the preferred mode of reconstruction. METHODS: In a first of its kind case series, we describe eight cases of complex maxillofacial defects managed by patient-specific implants at AFDC, New Delhi. All the designs went through stringent FEA analysis and GOM analysis to standardize the implant for achieving optimal functionality...

Removal of a part of or the entire orbit results in facial defect, causing psychological trauma to the patient, apart from anatomic loss. This case series presents 6 clinical cases of prosthetic rehabilitation of ocular defects related to post-COVID-19 ROCM by both analog and digital workflow. The basic objective of this case series was to achieve a well retained, user-friendly, maxillofacial ocular prosthesis with esthetic accuracy. Unique size and shape of the ocular defect in each case, variety of skin tones, age range of patients and compromised neuromuscular control made each of the six cases challenging...

PURPOSE: Mucormycosis is a type of fatal infectious disease, rarely involved in the oromaxillofacial region. This study aimed to describe a series of 7 cases with oromaxillofacial mucormycosis and to discuss the epidemiology, clinical features, and treatment algorithm thereof. METHODOLOGY: Seven patients in the author's affiliation have been treated. They were assessed and presented as per their diagnostic criteria, surgical approach, and mortality rates. Reported cases of mucormycosis originally happened in craniomaxillofacial region were synthesized through a systematic review so as to better discuss its pathogenesis, epidemiology, and management...

Oral fungal infections are opportunistic and due to impaired host resistance. The increasing number of immunosuppressed individuals contributes to rising numbers of mycoses worldwide, and the ease of global migration has allowed the geographic range of endemic mycoses to expand. Deep fungal infections can clinically mimic other pathologic conditions including malignancy. This review highlights the pathogenesis, clinical features, diagnosis, and treatment recommendations of eight fungal infections that can be encountered in the dental setting...

An invasive fungal infection caused by saprophytic and aerobic fungi Rhizopus, Rhizomucor, and Cunninghamella genera of the family Mucoraceae is known as Mucormycosis. Typically, Mucormycosis manifests in patients with conditions like uncontrolled diabetes, renal failure, patients receiving chemotherapy, long term steroid therapy or patients who are immunocompromised such as Acquired Immuno Deficiency Syndrome. The authors report a case of mixed opportunistic fungal infection of Mucormycosis and Aspergillosis following maxillofacial trauma that was treated by both medical and surgical line of management...

BACKGROUND: In the wake of the second wave of the COVID-19 pandemic, a substantial number of individuals were afflicted by orofacial mucormycosis post-COVID. The immunocompromised state rendered by the SARS-COV2 (Severe Acute Respiratory Syndrome Corona Virus 2) infection provides a breeding ground for the opportunistic mucor invasion. Corticosteroid and COVID-induced hyperglycemia contribute to the unhindered progress of the mucor infection in these patients. The sino-nasal region serves as the entry point and rapid progress of the disease to the oral cavity, mid-face, orbits, and ultimately the brain proves fatal...

AIM: During second wave of COVID pandemic, India faced heavy surge of mucormycosis. Treatment option for these patients included either total or partial maxillectomy with primary closure. Rehabilitation of these patients became challenging because of their age and size of defect. The purpose of the present study is to present a new digital technique for the fabrication of patient-specific zygoma implants (PSI) and to report on its survival and complication rates. MATERIAL AND METHODS: Total 21 patients who had undergone either partial or total maxillectomy after mucormycosis and who were disease-free clinically and radiographically for 6 or more months post-resection were rehabilitated using patient-specific zygoma implant...

BACKGROUND: Three dimensions (3D) modeling, printing, and manufacturing can help in personalized and customized surgical reconstruction of complex defects in the craniofacial region with precision by manipulating tissues based on the preoperative assessment, planning the shape of metal and alloplastic materials, and reduction in the total cost and time of the surgery. AIM: The present survey study aimed to assess the approach of treating surgeons towards the role of 3D printing in post-op rehabilitation of palatal bone loss by mucormycosis...

AIMS: Mucormycosis is a rare and aggressive fungal infection with a high mortality rate because of its rapidly progressive and destructive nature. The oral cavity is often affected under opportunistic conditions. We report a 34-year-old woman diagnosed with acute myeloid leukemia complained of slight swelling on the right side of her face with toothache and gingival swelling. An incisional biopsy was performed, and the specimen analysis revealed broad aseptate hyphae with a ribbon-like appearance, which is characteristic of opportunistic Mucorales infection...

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